Thursday, November 20, 2008

Do Stem Cells Grow Stems?


Picture from Wikipedia.

A report came out earlier this week that I have been mulling over and trying to figure out. Actually, the report itself isn't difficult to understand and it's fairly exciting. First read the report:

From Stuart Wong, of the MS Society:
Summary:

· An experimental treatment offered at a clinic in Israel may alter the
natural course of primary progressive multiple sclerosis and lead to some
recovery of function in some patients.
· Early data from about 25 patients suggests that the "mesenchymal" stem
cell treatment can repair existing damage to the nerve cells. Mesenchymal
cells exist in one's own bone marrow and can turn into heart tissue, bone,
cartilage and nerve cells.

· The procedure involves removing mesenchymal stem cells from a patient,
culturing them and preparing them for infusion. The cells are then injected
back into the patient either directly into the blood, the spinal fluid or
both.

Key messages related to this story are as follows:

· The ease of isolation and culturing mesenchymal stem cells makes them
attractive for investigation as a potential therapy. However, further work
and results are required to further our understanding of the abilities of
mesenchymal cells in relation to MS.

· Dr. Mark Freedman, an Ottawa researcher with expertise in bone marrow stem
cell treatments is planning an international meeting on mesenchymal stem
cell treatments and hopes to eventually begin a clinical trial in Canada.

· The MS Society of Canada will be watching these developments very
carefully and will post new information on www.mssociety.ca when available.

Me again. Dr. Freedman spoke at a meeting I attended a few years ago discussing his ongoing experiment with bone marrow transplants for MS patients. What he said is best summed up as follows (this is in response to a question about the experiment found on the MS Society website):
It is true that no patient thus far has had either a relapse or evidence of new MRI lesions and all seem to have remained fairly static with regards to their EDSS going out now 5 years plus, but it is highly unlikely for this treatment to become mainstream for MS. Not only is the whole treatment costly and risky but it is still considered to be experimental. In a highly selected group of patients it might become a consideration.
As to how it will enlighten us about MS, it is important to first understand what is unique about these patients. By the time we make a diagnosis, most patients have had their illness for some time, so figuring out what ‘kick-starts’ the disease is near impossible. In order to do this, we must look at a time when the disease begins. This is what we were intending to do in our patients after wiping out the old immune system and watching the new one renew, presumably with the disease. In effect, we did not believe that the treatment would completely stop the disease. However, watching the immune system re-develop in patients may give us a clue as to what may have gone wrong to begin with. We are comparing some of the immune aspects prior to the transplant with those afterwards to see what changes take place that might account for the well-being of patients following the treatments. We also recognize today that inflammation can be both good and bad. In MS, especially the patients enrolling in this study, it is clear that there is an imbalance of inflammation with the ‘bad’ type dominating. The transplant procedure wipes out both types, but upon recovery, the immune system seems to only be capable of ‘good’ inflammation. Understanding how to identify this type of inflammation may be key to earlier less toxic types of treatment.

Me again. Dr. Freedman said (at the meeting) that in essence the experiment has been a failure since none of the patients has had a redevelopment of MS and the objective was to observe the pathogenesis of the disease, to see how it develops. The good thing to come out of this experiment is the apparent halt of MS in these patients.
I have been looking for a few days and sending e-mails to MS professionals to find out exactly what the Israeli researchers have done that is different from what Dr. Freedman is doing. And that is where I have stalled. It's easier to find instructions on building a nuclear device than it is to find out what the Israeli team has done. I am confident that once Dr. Freedman finds out, the rest of us will know soon afterwards.

It is another piece of the puzzle. It's times like these, though, that I wish I had become a brain surgeon like I wanted when I was little. Then I think I'd understand all this stuff better and I might even have a little pull with the medical community.

S.
Did you know it was a couple of Canadians who pioneered the field of stem cells?

4 comments:

Jen said...

Hi Shauna--

This research is exciting and hope-inspiring. I wish the U.S. would do more stem cell research and I think pres-elect Obama is on board with this. Stem cell research presses such a button with a lot of people because a great deal of it uses embryonic cells (they at present seem to be the most viable and effective.) But this Israeli research sounds like it could help MS patients by using their own adult stem cells from their bone marrow. I wonder if the procedure will become less expensive if it ever becomes mainstream and is perfected as the years go by. So many variables. It's interesting that in order for the scientists to see how the stem cells help, they need someone to relapse, but it's working so well that that's not happening to any of the test subjects. Kinks to work out.

My dad recently gave me an article about adult stem cells proliferating into cancer cells at a much higher rate than other types of cells. So I'm completely confused about what is going on with stem cells and what is safe and what is most effective. Gotta read more about it and see. I'm hoping that the adult cells will prove more effective in the future.

Thanks for the informative post and article. Let's hope Candada is more progressive than the US in terms of stem cell studies and eventual therapies. Sounds like this might be the case with Dr.Freedman.

Sincerely,

Jen

Shauna said...

Jen,

Both the Israeli and Canadian teams are using autologous stem cells - meaning the patient gets his or her own stem cells back. This is where my confusion lies (or lay). I'm trying to find the difference in the treatments.

I can't comment on the stem cells proliferating into cancer cells...bone marrow transplants are done all the time, and with a great success rate, to treat certain types of cancer.

But it is exciting research.

S.

Merelyme said...

This sure is fascinating stuff. I wish I understood any of it.

You know one thing I don't understand is...how do they determine when the disease starts. For me...I had an isolated incident of optical neuritis over ten years ago. The MRI at that time showed no lesions. So advance to ten years later...I have lesions. When did they appear? How and why did that transformation take place?

Lots of mysteries with this illness for sure.

Shauna said...

Merelyme,
When I was diagnosed and was being admitted to the hospital for steroid treatment, the admitting nurse looked at my chart and asked, "How long have you had MS?" I looked at my watch and said, "About an hour and a half". That's when I found out it was MS. But obviously I'd had it much longer. Was it weeks, months, or years? No idea. And right now, we can't tell when the disease begins or how it begins.

That's why Dr. Freedman's research was and still is important. His patients are being monitored very closely and having scans frequently to determine any disease activity. Until we develop a see through skull or have scans every day we can't really tell when the disease begins.

As to why it begins in the first place? Ha! If I knew that I'd be a nobel laureate. Or at least really famous in MS circles.

S.